♪ Bob and Brad, ♪
the two most famous physical therapists on the internet.
- Howdy folks. I'm Bob Schrupp, physical therapist,
- Brad Heineck, physical therapist.
- Bob and Brad, the most famous physical therapists
on the internet.
- In our opinion, of course, Bob.
- Today we're going to talk about swollen, painful
ankle treatments at home.
Do it right, darn it.
- Yes, Bob. You know, this is a treatment,
we did have an ankle,
a swollen ankle video before, very popular.
And there's one section of it,
I skipped through it pretty quick.
- Right, so you're going to go into more detail on it.
- Right. So you do it right,
because if you don't do it right,
there can be problems for ankle, foot, calf swelling,
whether it's from trauma, like an ankle sprain,
and big swelling.
- Right.
- Or if you have lymph.
- lymphedema, right.
- lymphedema and you've got that chronic swelling
that you're trying to get rid of.
- It's good for both cases.
- Absolutely.
- So.
- So, Bob, what else do we have?
- Well are we doing a give away?
- Oh we are?
- Yeah, oh we're doing a booya give away.
- Boo, here, catch, Bob.
Oh no, the one's behind you, give it back, yeah.
Okay, we've got to get going on this, Bob.
Oh, booya!
- Just go to our give away section.
(both laughing)
Let's get started.
- All right.
So again, we're going to use compression garments, okay.
And you've probably, maybe you've heard of it,
there's all different types
of compression garments out there.
You can buy socks.
- You can get compression socks that are, you know,
kind of made for you.
- Right.
- Hard to put on.
- They're hard to put on,
and they're quite expensive.
- Expensive and they're not that comfortable,
in my mind.
- Yeah, yeah. And I think that varies.
- Sure.
- I've worn them and I think they're comfortable,
but I have to get them on and get them off,
so I don't want to do it.
- Right.
- We're going to show you an option
that both Bob and I have used,
probably at least for a decade,
in the clinic,
and it's much cheaper.
- Right.
- It works well, and it's called Tubigrip.
- Right.
- And, what it is, it's a material,
and it's an advantage to have open end.
- Right, right.
- We're going to talk about that in a little bit,
but it stretches only one direction.
It doesn't stretch this way,
but it stretches the other way.
As we can see.
- So it gives you some compression.
- Yep. And this will give 10 to 15 millimeters
of compression,
which is typically what you're looking for
when you start out.
- Sure.
- You don't want to start out too tight.
So it's a great garment,
we've got good experience with it.
And so shall we go on?
- Yeah, show how to put it on me.
- So, again, we're talking about swelling.
Could you get your foot up there, Bob?
- Sure.
- Now obviously Bob does not have any swelling,
but if we're going to imagine, typically.
- Probably some smelling.
(Bob laughs)
- Yeah, smelling, exactly right.
Whoa.
But the foot will swell in the forefoot,
around the ankle,
and oftentimes all the way up into the calf.
- [Bob] Yeah.
- So we want to have the garment from here,
not over the toes,
but from the base of the toe line
to just below the knee.
- [Bob] Gotcha.
- [Brad] Okay.
Now, first thing you need to do is get the right size.
- [Bob] Right.
- [Brad] And this will come,
and they put it in letter sizes,
A, B, C, D, E, F, G, I think up to H
or something of that nature,
and with Tubigrip, go to tubigrip.net,
and you're going to come up with.
- It's .net.
- Yeah. Yep, exactly.
- Okay.
- Yeah, you're right. Yeah, that's what I put on.
- Yeah.
(both laugh)
- And you're going to see a chart down there,
and they ask you to measure, with a tape measure,
around the widest part,
which often times, it could be the calf,
or it could be the ankle,
measure that, go to the chart.
- I've got a question.
- Oh yes.
- Is it always comes to 10 to 15 millimeters of pressure?
- Tubigrip does.
- It does? Okay.
- You can double it and you can get more.
- Sure.
- There's a little point I want to add about that.
- Okay.
- So, you measure it and, I believe, what is this?
- So you're measuring from.
- This is for my mother, actually.
- Right.
- And hers came up a size F.
- Okay.
- Okay? So I got the size F.
- Again, you measure at the widest point.
- Right.
- Biggest girth of the calf.
- Right. And in her case it's around the calf.
- [Bob] Sure.
- [Brad] You know, if it's a swollen ankle,
like if you had a big swollen ankle,
you would measure it there.
You can visually see it.
- [Bob] Oh the biggest point?
- [Brad] Yes, the largest circumference, there we go.
- Okay, good.
- Now you'll see, don't get confused,
because it confused me,
on Tubigrip, they say double this up,
put on one layer, and then put a second layer over the top.
So I had to go to,
we have a therapist, a doctor of therapy.
- That works on this all the time.
- Yeah, and he took the full course,
got certified in it, I could consider him an expert.
I got ahold of him and I said, now Aaron,
we've got some videos that are well liked by him.
- Right.
- Do I put two or just one layer of the Tubigrip on there?
And he said one.
- One.
- Start out with just one, and for the vast majority,
that's going to be what you want.
- Sure.
- So, don't get confused by that.
Cost?
If you go online and buy it.
- This is quite a bulk here.
- Yeah, well you get 10 meters,
but it's only $25.
- Or 10 yards.
Right. Fairly inexpensive.
- I did buy this by the foot down at the local pharmacy,
and I paid more for enough for two fittings on my mother
than I did for this.
- Wow, yeah, yeah.
- This is going to last a long time.
- Exactly.
- You can reuse it.
You need to hand wash it, air dry it.
Don't put it in the machine.
You'll find.
- Once it looses its elasticity you got to stop using it.
- Yeah, after a while. And you know,
sometimes they get dirty or whatever.
- Right, right. Yeah.
- It'll last for, you know,
if they keep it clean and are careful,
it'll last, you know, a few weeks.
- Sure.
- Up to it.
So, it works well.
So what we're going to do,
I'm going to show you how to measure it.
We got the size. Size. What did I say?
- You got the right size.
- Yep. And now don't measure,
with a tape measure, here to here.
You can do that, and I've done it that way,
and it sometimes does not turn out the right length.
You want to do this Bob?
- [Bob] Sure.
- [Brad] So what you do is pull it over the foot
while it's still on the tube.
There you go.
Now.
- [Bob] Right about there?
- Yep. Now this.
- [Bob] Don't go into the crease though, right?
- Right. Do not go up into the crease,
because that's going to have it curl over.
- [Bob] Right.
- [Brad] And we'll talk about that in a little bit, too.
So right about there is good.
Better to be a little long than a little short.
- [Bob] Sure.
- [Brad] Because you can always cut it off.
But that's good.
Now, yeah. Bend your knee one, Bob.
Yeah, you're not up in the crease
- [Bob] Nope, nope.
- [Brad] Because when you sit down,
if you get it up into the crease of the knee,
then it has a tendency to roll down.
So I want to go, take my little Sharpie here,
and put a black line right there.
There we go.
Now, let's see if I can cut this off.
- [Bob] Watch this.
(Brad laughs)
Slide it down.
- [Brad] Oh, slide it down a little bit? There ya go.
- [Bob] Yep.
- [Brad] It's kind of hard,
you kind of have to work this like this.
- [Bob] Sure.
- There.
- [Bob] Slide it down.
- There we go.
- Don't rely on the accuracy of Brad.
- Yeah, I don't want to cut into those,
Bob's a tall guy, but we don't want to shorten him up.
(Bob laughs)
All right, so very easy to cut.
There we go.
You know, often times both legs will need this
if it's a lymphedema problem.
Yeah.
- Oh it feels good, actually.
- Yeah. See? Yeah.
- It really does.
- Exactly, kind of feels like you're,
you know, it's breathing.
- I just, you know,
I'm trying to remember how much compression socks are.
- Yeah.
- [Bob] Do you remember?
- Cost wise?
- Yes.
- Oh they, $35, $40 somewhere.
- I wonder if this would be easier to put on.
- They are, the ones,
like I tried the compression socks with my mother.
She couldn't do it, and I could do it,
but she didn't like them.
She said forget it.
(Brad makes pfft sound)
- I was just thinking, like when I'm at a standing desk,
and I want to stand a lot.
- Yeah.
- You know.
- Very good, very good.
Should we continue on?
- [Bob] Sure.
- Now, you should be able to put two fingers in here,
if you want to double check the tightness.
And there should be no,
it shouldn't be wrinkled up and loose.
So it should be compression all the way
from the toes to.
- [Bob] And you wear throughout the day?
- [Brad] Absolutely, throughout the day.
- [Bob] What about at night?
- [Brad] Not at night.
- [Bob] Not at night.
- [Brad] Nope, we don't. We want to take them off at night.
Wash them by hand, leave them dry over.
Like what my mother does, she has two pair, and then.
- Washes one.
- One's washing and drying while you wear the other pair.
- Sure.
- There you go.
- Just hand washing?
Hand wash and air dry?
- Well what else would you, I said that.
(Bob laughs)
Tanner, didn't I say that already?
No, it's good that you bring it up, Bob,
just to reinforce that.
Now this is a big worry,
and this is the part where,
if you don't do it right,
can actually reverse.
- Make it worse.
- Make the lymphedema or the swelling worse.
And what can happen is these things can roll down,
and it, and you see this often,
and it rolls into like this,
and it actually creates a tourniquet.
- [Bob] Right.
- [Brad] It's not enough
to prevent blood flow going down into the leg,
but it is enough to prevent the lymph.
- [Bob] It doesn't take much.
- [Brad] Yep, because a lymph
actually flows just under the skin,
and it needs to get up, back into the system.
- [Bob] Right.
- [Brad] And this will act like a tourniquet,
cut that off.
And you'll see, like if I've had someone like this
for four hours, and you roll this down,
you'll see an indent.
- Indent, yeah.
- Very obvious.
And that's no good, it's going to be a problem.
So just, the person wearing it needs to monitor it,
and continue, you know,
every hour or so check it,
and roll them back up where they need to be.
- Right.
- If they roll down.
However, if the person doing it, you know,
is confused, has some Alzheimer, something of that nature.
- Right.
- And they won't remember to roll them up,
then what you're going to want to do
is get some Coban,
C O B A N,
and it's a type of tape that's stretchy,
and it only sticks to itself.
You put it on your skin and it does not stick,
and it works very well.
One little, I'm going to show you how this works,
where you just go at the top,
you can see I'm stretching it.
It doesn't stick to that,
it doesn't stick to the skin.
And I'm just going to go around,
but, look at this.
It sticks to itself.
- [Bob] Right.
- Not really sticky, but,
and we're going to go like this.
And one or two layers would be good.
And we'll cut that off.
- [Bob] Now you don't want to have that too tight either.
- Right. Yeah.
- [Bob] Just enough to hold it in place.
- Exactly,
because then you have another tourniquet.
But again make sure, because you get different width,
a couple inches is right.
I wouldn't go less than an inch and a half.
- [Bob] So why is this camouflage?
- [Brad] Well that's a good question.
And this is the point that, Aaron,
he said that when he went to the course,
it's a week long comprehensive course,
he said, you can buy Coban from the medical supplier,
you're going to pay X amount.
- Right.
- You can go, and this is what they recommended,
just go to a local Farm and Fleet,
that's in this area.
- Yeah.
- Or in other words, or a vet.
Online, you can go to get veterinary Coban.
It's the same product, they use it on horses or cows.
Exact same product.
Now this, I didn't know this,
but I was looking for camouflage for my turkey hunting gun,
because you want to camouflage it.
- Sure.
- And I get it and it's like it's Coban.
It's camouflaged Coban.
It's the exact same product.
It was very cheap, it was like a fourth of the cost.
- Wow, isn't that amazing.
- Compared to the medical.
Yeah, so save yourself some money.
You know, if there's anybody that's a turkey hunter
then you can.
(Bob laughs)
- Double duty. It can serve double duty.
- Yeah, it comes in different colors and what not.
- Sure.
- But that's your choice.
So that's just a little money saver for you.
- Yeah. Would you do it on both ends or really?
- Typically it's just up here that happens.
- Sure.
- You could do it down here, if when you put the shoe on.
- It wrinkles up, yeah.
- It wrinkles up. You just have to be careful
that the shoe has enough room.
- Sure.
- So you don't get a tight toe botch.
- Again to reiterate, the fluid has to move out
of the ankle and foot and move up into the body.
- Exactly, right.
- You process, actually up into the chest.
- Right. Oh yeah, yeah. We're going to get into that.
Here's the box it comes in, just so you know.
And they have a nice chart.
You can use this on all different body parts.
I did want to do one thing.
I think we pretty.
- You were going to do a demo, weren't you?
- Yeah. I wanted to do a demo,
how this, it's brand new out of the box,
I cut it off like this.
And I was thinking about this at home,
it's like, how comfortable and breathable is this?
So this is what I did at home to show my wife.
- Oh you (indistinct). Look at this.
- Watch this.
It goes right over your head.
It feels good.
- And you look so much better.
- Yeah. Maybe I should do this for a typical.
- You could be a super villain.
- It's kind of hard to eat.
- Yeah, you really look creepy.
You could go to Halloween like that.
(indistinct crew talking)
- Yeah.
- Yeah, so people will start using this
for Halloween.
- Right, for Halloween.
- But, it was amazing. It's like,
it's reasonably comfortable.
- Is it really?
- I've got a barrel head, you know.
- Yeah.
- When I used to be in welding class,
back in the day, when I had,
you know, everyone put my welding helmet on
and it would like, it would just fall on their head.
- Fall. Right, right.
- And they'd have to tighten it up.
So that's how I know my head's much larger.
- Sure.
- But it's hollow, I mean.
- Yeah.
- If I had the brains in there that.
- There'd be a lot of air.
- But that's another story.
That looks good on you, Bob.
- Okay thanks.
- I think you could continue wearing these.
- Yeah, I'll keep it on all day.
- Be careful and good luck with those swollen ankles.